Should lung transplant recipients routinely perform airway clearance techniques? A randomized trial

Respirology : Official Journal of the Asian Pacific Society of Respirology
Prue E MunroGregory I Snell

Abstract

Despite the widespread use of airway clearance (AC) techniques to clear excessive secretions and improve lung function, little is known about their efficacy following lung transplantation (LTx). This study compared the effects of two AC strategies (proactive vs reactive) on a range of clinical outcomes following LTx. A prospective randomized trial was conducted. Uncomplicated patients were recruited 1 month postoperatively. Patients performed AC using positive expiratory pressure either twice daily (proactive strategy) or only in the presence chest infection (reactive strategy). Lung function (FEV(1) and FVC), CXR (Brasfield score) and bronchoscopic airway characteristics (anastomotic healing, patency and secretions) were assessed at 1, 2 and 3 months postoperatively. Adherence was measured. Of 60 consecutive patients, 36 (18 proactive, 18 reactive) were recruited and completed the study. Both groups improved lung function (FEV(1) 72 +/- 4% to 81 +/- 4%, P < 0.0001; FVC 69 +/- 3% to 81 +/- 3%, P < 0.0001) and Brasfield scores (17.8 +/- 0.5 to 19.8 +/- 0.5, P < 0.002) over the study period. No significant differences for any outcome were found between the two groups. The vast majority of patients had fully healed, 100% patent an...Continue Reading

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Citations

Mar 13, 2018·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Benjamin James TarrantGreg Snell
Jan 12, 2019·Transplant International : Official Journal of the European Society for Organ Transplantation·Benjamin James TarrantAnne Holland
Oct 8, 2020·Pediatric Transplantation·Emma Shkurka, Helen Spencer

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